Owolabi Ogunneye

Parainfluenza virus infection associated with posterior reversible encephalopathy syndrome: a case report

IntroductionPosterior reversible encephalopathy syndrome is a clinical and radiological entity. The most accepted theory of posterior reversible encephalopathy syndrome is a loss of autoregulation in cerebral blood flow with a subsequent increase in vascular permeability and leakage of blood plasma and erythrocytes, producing vasogenic edema. In infection-associated posterior reversible encephalopathy syndrome, a clinical pattern consistent with systemic inflammatory response syndrome develops. Parainfluenza virus has not been reported in the medical literature to be associated with posterior reversible encephalopathy syndrome.Case presentationWe report herein the case of a 54-year-old Caucasian woman with posterior reversible encephalopathy syndrome associated with parainfluenza virus infection who presented with generalized headache, blurring of vision, new-onset seizure and flu-like symptoms.ConclusionInfection-associated posterior reversible encephalopathy syndrome as well as hypertension-associated posterior reversible encephalopathy syndrome favor the contribution of endothelial dysfunction to the pathophysiology of this clinicoradiological syndrome. In view of the reversible nature of this clinical entity, it is important that all physicians are well aware of posterior reversible encephalopathy syndrome in patients presenting with headache and seizure activity. A detailed clinical assessment leading to the recognition of precipitant factors in posterior reversible encephalopathy syndrome is paramount.

Acute Cytomegalovirus Colitis Mimicking Exacerbation of Ulcerative Colitis: Precipitating or Coincidental?

Cytomegalovirus colitis is an uncommon cause of diarrhea in older adults, despite the high seroprevalence of cytomegalovirus in the general population: 40%-70% of adults in higher socioeconomic groups, and up to 90% of adults in lower socioeconomic groups. The majority of primary cytomegaloirus infections in immunocompetent adults are asymptomatic r associated with mild mononucleosis-like syndrome. Cytoegalovirus produces characteristic cytopathic effects, consistng of a large 25to 35m cell containing a basophilic intranuclear inclusion, which is sometimes surrounded by a clear halo. Immunohistochemistry of the biopsied tissue using monoclonal antibodies and in situ DNA hybridization enhances the sensitivity of the histologic analysis.